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Video Lecture of Performing Safe TVT, TOT and TVTO
For Gynecologist / May 9th, 2020 9:24 am     A+ | a-



The key difference between a TVT and a TOT procedure is the way the surgeon reaches the urethra to position the tape. Also, the tape material may differ depending on the procedure. Transobturator tape (TOT) procedure? This is the procedure for urinary stress incontinence and it is performed under a general or spinal anesthetic. A small incision is made on the wall of the vagina and the permanent tape is introduced via the vagina to sit under the urethra.


TVT (tension-free vaginal tape), TOT (transobturator tape), and TVTO (transvaginal tape obturator) are all minimally invasive surgical procedures used to treat stress urinary incontinence in women. While these procedures are generally safe, there are some risks and precautions that should be taken to ensure a successful outcome.
 
Here are some steps that can help ensure safe TVT, TOT, and TVTO procedures:
 
Patient selection: The first step in ensuring a safe procedure is to select the right patient. Patients who are good candidates for these procedures have genuine stress urinary incontinence and have failed conservative treatments like pelvic floor exercises or bladder training.
 
Preoperative evaluation: It is important to perform a thorough preoperative evaluation to identify any conditions that may increase the risk of complications. This includes a complete medical history, physical examination, and any necessary diagnostic tests.
 
Informed consent: The patient should be fully informed of the risks and benefits of the procedure, including the possibility of complications such as bleeding, infection, and urinary tract injury.
 
Proper training and experience: The surgeon performing the procedure should have proper training and experience in the technique being used. They should be familiar with the anatomy of the pelvic floor and the potential complications of the procedure.
 
Surgical technique: The surgical technique used should be appropriate for the patient's anatomy and the type of incontinence being treated. The procedure should be performed with meticulous attention to detail to minimize the risk of complications.
 
Postoperative care: After the procedure, the patient should be monitored closely for any signs of complications. They should be instructed on proper postoperative care, including activity restrictions, wound care, and bladder management.
 
Follow-up: Follow-up appointments should be scheduled to monitor the patient's progress and ensure a successful outcome. The patient should be encouraged to report any symptoms or concerns to their healthcare provider.
 
In summary, safe TVT, TOT, and TVTO procedures require proper patient selection, preoperative evaluation, informed consent, proper training and experience, appropriate surgical technique, postoperative care, and follow-up. By following these steps, the risk of complications can be minimized, and the patient can achieve a successful outcome.

The advantages of performing safe TVT (tension-free vaginal tape), TOT (transobturator tape), and TVTO (transvaginal tape obturator) procedures are numerous. These minimally invasive surgical procedures are highly effective in treating stress urinary incontinence in women, which can have a significant impact on quality of life.
 
Here are some advantages of performing safe TVT, TOT, and TVTO procedures:
 
High success rates: These procedures have high success rates, with most patients experiencing significant improvement in their symptoms of stress urinary incontinence.
 
Minimally invasive: These procedures are minimally invasive, meaning they require small incisions and minimal tissue disruption. This can lead to less pain, scarring, and a quicker recovery time compared to traditional open surgery.
 
Outpatient procedure:
TVT, TOT, and TVTO procedures are usually performed on an outpatient basis, meaning the patient can go home the same day as the surgery.
 
Low complication rates: With proper patient selection, surgical technique, and postoperative care, the risk of complications associated with these procedures is relatively low.
 
Shorter hospital stay: Since these procedures are minimally invasive and usually performed on an outpatient basis, they can result in shorter hospital stays and lower healthcare costs.
 
Improved quality of life: For many women, stress urinary incontinence can have a significant impact on their quality of life. By successfully treating this condition, women can regain their confidence and improve their overall well-being.
 
Reduced need for medication: Women with stress urinary incontinence may need to rely on medication to manage their symptoms. By treating the underlying condition with a TVT, TOT, or TVTO procedure, they may be able to reduce or eliminate the need for medication.
 
Quick recovery time: With proper postoperative care, most women can return to their normal activities within a few days of the procedure.
 
Long-lasting results: The results of TVT, TOT, and TVTO procedures are generally long-lasting, with many patients experiencing improvement in their symptoms for years after the procedure.

Improved sexual function: In addition to improving urinary incontinence, these procedures may also improve sexual function in women by providing support to the pelvic floor muscles.
 
In summary, performing safe TVT, TOT, and TVTO procedures have several advantages, including high success rates, minimally invasive techniques, outpatient procedures, low complication rates, shorter hospital stays, improved quality of life, reduced need for medication, quick recovery time, long-lasting results, and improved sexual function. Overall, these procedures can be a safe and effective treatment option for women with stress urinary incontinence.
 
While TVT (tension-free vaginal tape), TOT (transobturator tape), and TVTO (transvaginal tape obturator) procedures are generally safe and have low complication rates, there are some risks associated with these procedures. Here are some potential complications of these procedures:
 
Bleeding: While bleeding is rare, it can occur during or after the procedure.
 
Infection: Infection is a rare but serious complication that can occur after any surgical procedure. Antibiotics may be given before or after the procedure to reduce the risk of infection.
 
Urinary tract injury: There is a small risk of injury to the bladder, urethra, or other structures in the pelvic area during the procedure.
 
Urinary retention: Some women may experience difficulty emptying their bladder after the procedure, which may require the placement of a temporary catheter.
 
Mesh complications: The use of mesh in these procedures can lead to complications such as erosion, infection, pain, and discomfort. While rare, these complications can be serious and may require additional surgery to remove the mesh.
 
Pain: Pain during or after the procedure is common but is usually managed with medication.
 
Vaginal scarring: Some women may experience scarring or adhesions in the vaginal area after the procedure.
 
Sexual dysfunction: While rare, some women may experience sexual dysfunction after the procedure, such as pain during intercourse.

Anesthesia-related complications: There is always a risk of complications associated with anesthesia, such as allergic reactions or breathing difficulties.
 
Nerve injury: The procedures involve placing a sling or tape near the pelvic nerves, which can cause nerve damage and result in symptoms such as chronic pain or numbness.
 
Vaginal perforation: In rare cases, the sling or tape may perforate the vaginal wall, which can cause bleeding or infection.
 
Device failure: There is a small risk of device failure, where the sling or tape may become displaced or dislodged, requiring additional surgery.
 
Recurrent incontinence:
While TVT, TOT, and TVTO procedures have high success rates, some women may experience recurrent stress urinary incontinence after the procedure.
 
Blood clots:
Surgery, particularly longer procedures, can increase the risk of blood clots in the legs or lungs.
 
Bowel or bladder problems: In rare cases, the procedures may cause problems with bowel or bladder function, such as constipation or difficulty urinating.
 
It is important to note that many of these complications are rare, and the benefits of the procedure often outweigh the risks. The risk of complications can be minimized by choosing a qualified and experienced surgeon and carefully following postoperative instructions. Women who are considering TVT, TOT, or TVTO procedures should discuss the risks and benefits with their healthcare provider and ask any questions they may have about the procedure.
 
7 COMMENTS
Dr. Joshua Coppen
#7
Nov 8th, 2023 5:25 am
The distinction between TVT and TOT procedures lies in urethral tape placement and material. TOT, used for urinary stress incontinence, involves a vaginal incision and tape insertion. These minimally invasive surgeries offer effective treatments with manageable risks and precautions.




Dr. Drishti Dhamija
#6
Jun 3rd, 2020 9:53 am
Thank you very very much for Excellent video!. Thanks for sharing this video of Video Lecture of Performing Safe TVT, TOT and TVTO.
Dr. Deepshikha
#5
May 30th, 2020 8:56 am
Thanks Dr. Mishra for sharing this educative and impressive Lecture of Performing Safe TVT, TOT and TVTO. you are great surgeon and teacher in this world.
Dr. Rajni Singh
#4
May 23rd, 2020 4:29 am
My words are less to describe this video. Thanks for providing great information about TVT, TOT and TVTO.

Dilara
#3
May 20th, 2020 12:52 pm
Well video demonstration of TVT, TOT, and TVTO with perfect explanations and detailed information of very easy way to learn. Thank you so much for this video.
Dr. Vinod Kumar
#2
May 16th, 2020 5:17 am
Very useful information for all. Thanks for your knowledge sharing of TVT, TOT, and TVTO video.
Dr. Radhya
#1
May 14th, 2020 9:51 am
Thank you so much for the detailed information. Sir, I know that you are very helpful for others. Now you have proved yourself.
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